How do I restore my sense of smell after COVID-19?

While the coronavirus is raging in India, turning the country into hundreds of funeral pyres, scientists are trying to understand how a COVID-19 infection affects human health.

The latest findings are, alas, disappointing – according to a paper recently published in Nature, 30 days after discharge, coronavirus survivors had an increased risk of arrhythmia, tachycardia, diabetes, depression, muscle weakness, fatigue, shortness of breath and a host of other conditions. Moreover, the mortality rate of covidomers was 1.46-1.73 times higher.

Another characteristic feature of coronavirus is anosmia – loss of the ability to smell. Sometimes anosmia can manifest itself partially or in the form of distortion of smells. Although anosmia can hardly be compared to cardiovascular and other diseases developing after COVID-19, such a condition significantly worsens the quality of life. Just imagine what it’s like not to smell a spring thunderstorm and morning coffee or, on the contrary, instead of the smell of your favorite people, to smell rotting meat. Fortunately, scientists have been able to achieve significant results in the treatment of post-coital anosmia and have recently reported the discovery of a cure.

Consequences of COVID-19

It may be hard to believe, but the COVID-19 pandemic in the world is gaining momentum. Available vaccines, as experts have repeatedly pointed out, are predominantly distributed in developed countries, while people in developing countries (of which India is one) do not have access to vaccines. Moreover, as a result of the spread of the new COVID-19 strain in India, the country’s hospitals are overcrowded – all against a backdrop of severe drug shortages.

Meanwhile, the consequences of suffering COVID are truly frightening. In late April, the scientific journal Nature published an article whose authors took a sample of 73,435 people who had covid but were not hospitalized and managed to live at least 30 days after diagnosis. For comparison, the control group had 4,990,835 people who did not have covid and were not hospitalized.

The results were disappointing – mortality among SARS-CoV-2 patients was 1.46 to 1.73 times higher; there was also an increased risk of diabetes, depression, cardiovascular and a variety of other diseases.

Biologist Alexander Panchin referring to the study, the authors also compared COVID-19 sufferers with those who had had the flu:

“Again, in addition to the increased risk of death in COVID sufferers, there were increased risks of a number of serious illnesses: the risk of kidney and heart failure and clotting disorders increased about one and a half times; acute hemorrhagic brain vessel disease and respiratory arrest were almost twice as common; the risk of acute pulmonary embolism and encephalitis was three times higher; the risk of myopathy was five times higher. And this, alas, is not a complete list of problems.

Anosmia after COVID-19

Among the serious post-CovID health problems described above are others that are less serious. Among them is anosmia, the loss of the ability to smell. But despite its seemingly innocuous nature, loss or distortion of the sense of smell (also a common symptom among coronavirus patients), anosmia can significantly worsen quality of life.

Recently, scientists suggested that such patients try to re-train their noses to learn how to sniff out certain smells. As the researchers note, this will take time, perhaps months, but if “you try to inhale at least four different scents twice a day, it may help you recover more quickly and completely without any unwanted side effects.”

This recommendation is based on an evidence-based systematic review. The authors of the review concluded that corticosteroids should not be the first treatment option for odor loss due to COVID-19. Corticosteroids are usually prescribed for those with a stuffy or inflamed nose, but in the case of postconvulsive anosmia, they don’t seem to work.

On the other hand, olfactory training is a more scientifically sound way to regain the ability to smell after a viral infection. “As a panel of experts, we strongly emphasize the initial consideration of odor training,” the researchers write. “Odor training has no known side effects and is inexpensive. Moreover, it is the only treatment available … backed by a robust evidence base.”

It should still be noted that comparing steroids and odor training methods for treating olfactory dysfunction after COVID-19 is somewhat incorrect, as no controlled studies have been conducted. Nevertheless, the idea of odor learning has been around for some time and has been used with great success to treat odor loss from other infections.

According to Sciencealert, scientists may need to implement the practice on an unprecedented scale in the case of post-smell anosmia. About 60% of those infected with COVID-19 have experienced impaired sense of smell, while about 10% have persistent symptoms that last for weeks or even months. Fortunately, it seems that most people do get better, and learning to smell may have something to do with it.

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For example, an early 2021 study of 1,363 coronavirus patients with olfactory dysfunction found that 95% of patients had regained their sense of smell after six months. Corticosteroids have also been considered as a treatment option, but this medication is not harmless. Such treatment can come with many unwanted side effects, including fluid retention, high blood pressure and mood swings.

In general, based on the available data, the authors join numerous other experts in urging caution. Until randomized placebo-controlled trials are conducted, treatment should begin with olfactory training rather than steroids.

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